How much rates vary
Facilitymedian $3,802 · 10th to 90th $759 to $11,482Professionalmedian $5,495 · 10th to 90th $4,266 to $7,586
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,801.89 Median $5,623.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,623.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,495.41 Typical High $5,623.41 | Professional | None | $5,128.61 | $5,495.41 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,466.84 Median $5,370.32 Typical High $6,760.83 | Professional | None | $4,466.84 | $5,370.32 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,818.38 Median $3,388.44 Typical High $4,265.80 | Professional | 62 · Two surgeons | $2,818.38 | $3,388.44 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $707.95 Median $851.14 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $707.95 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $616.60 Median $741.31 Typical High $954.99 | Professional | AS · PA/NP assist | $616.60 | $741.31 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $6,760.83 | Professional | None | $4,570.88 | $5,128.61 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $6,309.57 | Professional | None | $4,265.80 | $5,128.61 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,786.30 | $5,888.44 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $9,120.11 | Facility | None | $4,677.35 | $4,677.35 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,737.80 | $3,981.07 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3,235.94 Median $5,623.41 Typical High $11,220.18 | Professional | None | $3,235.94 | $5,623.41 | $11,220.18 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $9,332.54 | Professional | None | $3,235.94 | $5,370.32 | $9,332.54 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,630.27 Median $2,754.23 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,630.27 | $2,754.23 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,096.48 Typical High $1,122.02 | Professional | 53 · Discontinued | $1,047.13 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $3,890.45 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $776.25 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $549.54 Typical High $562.34 | Professional | 56 · Pre-op care only | $524.81 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,890.45 | $3,890.45 |
Where Virginia sits
The same service costs 8.4 times more in Wisconsin than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $28,671TX $3,407
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.